ABSTRACT
Purpose: This study was conducted to describe and validate a novel inflammatory score (IS) system in the management of infectious endophthalmitis. Methods: This was a prospective comparative non?interventional observational study. The study included the patients with clinical signs and symptoms of acute post?cataract surgery endophthalmitis (surgery within 6 weeks) with visual acuity from 6/18 to light perception. IS was scored by the clinical picture at two?levels of four ocular tissues on a scale of 0 (normal) to 4 (severe). Four masked graders of different levels of experience evaluated slit?lamp photographs. The concordance correlation coefficient was assessed between the slit?lamp clinical grading and photographic grading. We measured the concordance correlation coefficient, Pearson’s correlation (indicating precision), and the bias correction factor (indicating the accuracy). Results: The study included 43 eyes of 43 patients. The concordance correlation coefficient was 0.99 (95% CI 0.995 to 0.998). Both Pearson’s correlation coefficient and the bias correction were 0.99. The interclass correlation coefficient (ICC) was measured. The intra?rater ICC was 0.833 with good agreement (95% CI, 0.711 to 0.906; P < 0.001). Inter?rater ICC for consistency was 0.92 (95% CI 0.87 to 0.95). Inter?rater ICC for absolute agreement was 0.86 (95% CI 0.66 to 0.93). Conclusion: Currently used IS scoring in the study is a reliable, reproducible, and easy?to?apply scale to measure inflammation severity in endophthalmitis. We propose that it can have applications in decision?making for primary treatment and monitoring progression in acute infectious endophthalmitis
ABSTRACT
A 42-year-old male post-renal transplantation presented with sudden diminution of vision in the left eye. The right eye was lost following a failed vitreoretinal surgery 5 years ago. The patient had been hospitalized 4 months prior for coronavirus disease 2019 infection with a good recovery. The presenting visual acuity was 20/600 in the right eye and 20/250 in the left eye. Fundus examination revealed a sub-macular sub-retinal abscess in the left eye. Sub-retinal aspiration of the abscess revealed Candida albicans. The patient was managed with repeated intravitreal amphotericin B injections, following which the abscess resolved with scarring and vision improving to 20/60.
ABSTRACT
A 62‑year‑old hypertensive male presented with acute nonarteritic ischemic optic neuropathy (NAION) with contiguous macular edema and subretinal fluid in the right eye. Presenting vision was 20/1000. The patient was treated with intravitreal bevacizumab 1.25 mg/0.05 ml. At 1 month follow‑up, the macular edema and the optic nerve head edema completely resolved with a good visual improvement up to 20/40. The visual improvement was maintained at the last follow‑up 6 months postinjection. Intravitreal bevacizumab may be a good option for acute NAION especially in an unusual presentation with macular edema and subretinal fluid.